Registered Nurse Case Manager – Field

This is a fully remote position, open to applicants in Texas.

📋 Description

• Perform thorough assessments of members' medical and behavioral health needs, both telephonically and in person.

• Create and execute personalized care plans that adhere to clinical and program standards.

• Oversee and adjust care plan activities to enhance outcomes.

• Collaborate on multidisciplinary care evaluations.

• Recognize and escalate any quality-of-care issues.

• Motivate and coach members through effective engagement techniques.

• Inform and empower members in making healthcare decisions with their providers.

• Negotiate and organize suitable services and resources.

• Ensure documentation is accurate and timely, complying with regulatory, accreditation, and company standards.

• Act as a preceptor and mentor for new nursing and clinical staff.

• Assist with onboarding by instructing on policies, workflows, and best practices.

• Cultivate a supportive learning environment that encourages clinical excellence.

• Provide case management through both telephonic and in-person interactions.

• Engage in regular local travel for in-home member visits and occasional nursing or medical facility visits within the Dallas Service Delivery Area.

⛳️ Requirements

• Must possess a valid Registered Nurse license in Texas.

• Have a minimum of 3 years of clinical nursing experience.

• At least 1 year of experience in case management is required.

• Residency in the Dallas, Texas Service Delivery Area is mandatory.

• Must have reliable transportation and be willing and able to travel up to 75% of the time.

• An Associate Degree in Nursing is required.

• A direct/hardwired internet connection to a modem/router must be within 7 feet of the computer.

• Minimum internet speed requirement is 25 Mbps download and 3 Mbps upload.

• WiFi and satellite internet connections are not acceptable.

• A quiet, secure, and private designated home virtual workspace that complies with CVS Health and HIPAA standards is necessary.

• Employment must be conducted within the state and city of residence.

• Candidates must provide their own workspace furniture.

• Experience with Microsoft Office 365 or a similar Google Workspace is expected.

• Ability to operate multiple monitors and applications at the same time is essential.

• Must be able to communicate through email, calendar invites, Teams messaging, and virtual meetings.

• Capability to access secure systems such as VPN and EHR portals is required.

• Familiarity with computer security practices, managing strong passwords, and identifying suspicious emails or links is essential.

• Ability to independently troubleshoot common technical issues is necessary.

• A willingness to learn new skills as the work environment evolves is expected.

• A Bachelor’s degree in Science & Nursing is preferred.

• Experience with Managed Care Organizations is favored.

• Familiarity with the STAR Kids program is a plus.

• Bilingual proficiency in English and Spanish is preferred.

🏝️ Benefits

• A flexible work-from-home environment.

• Mileage reimbursement in accordance with the company's expense reimbursement policy.

• Provision of company equipment, including keyboard, monitor, computer, headset, and more.

• Medical coverage is provided.

• Dental coverage is available.

• Vision coverage is included.

• Paid time off is offered.

• Retirement savings options are available.

• Access to wellness programs.

• Additional resources to support physical, emotional, and financial well-being.

• Eligibility for CVS Health bonus, commission, or short-term incentive programs.